Written by – Paul’s Wife, A Therapist
Content Warning – you may find some of the content in this blog difficult or triggering. Please read with care.
Birth ‘Preferences’
During my pregnancy, I had spent quite a bit of time researching and planning my Birthing Preferences. I purposefully chose not to refer to it as a ‘Plan’ because I knew from my work as a Therapist, that plans change and having something too set in stone isn’t helpful with reconciling expectations of a birth, versus the reality of a birth. When we have a very set idea of what we want, and that doesn’t happen, it can be very hard to come to terms with.
I knew that ideally; I wanted a vaginal birth. I was open to pain relief although if I could get by with gas and air, then I would. I wanted lots of communication about what was going on and why, and ideally, I stated, I did not wish to be induced or have interventions (at least, not without good reasons that were explained to me so I could make an informed decision). I researched lots about hypnobirthing and planned to use breathing techniques, a calm dark room and music to help me to birth this baby with as little fuss as was possible.
Having heard a lot of negative birth stories in my role as a Therapist, I consciously listened to positive birth stories, including from one of my oldest friends who had what you can only describe as a textbook birth. There she was in the pool, no interventions, no tearing, everything went according to her plan, her husband announced the baby’s gender and that was that! She was the poster child for a perfect birth. I therefore considered the idea of the birth pool, however that scene in Peep Show where Mark has to use the little net to scoop out his partner’s poos from the water, put me off big style. When I was told that because I was under the care of the Consultant, they wouldn’t advise birthing the baby in the pool, I wasn’t overly bothered by this.
Our pregnancy hadn’t been a straightforward one since the start, and when, at one of the many appointments we had with the Consultant, we were told that there was a risk of the placenta failing towards the end of pregnancy, we weren’t exactly surprised. Apparently, it can be common among babies conceived via any fertility treatment, and no one really knows why.
We were reassured at the time that the growth scans were all showing baby developing nicely, and we were sent on our way.
When Things Changed
Within a few weeks, the midwife became concerned that my bump was measuring much too small for the gestation and immediately booked us in for another growth scan. To be honest, we weren’t concerned. We’d had lots of panicky moments during the pregnancy and had made it to 37 weeks so we chalked it up to another one of these and decided that we wouldn’t panic until we’d had the scan so we could see what was going on.
The scan confirmed that the baby’s growth had dropped from the 50th to the 10th centile and predicted that the baby would weigh 5lbs 2oz when they should have been heading nicely towards 7lbs. The placenta had failed, and we were told that our options were to either have the induction, or wait and run the increased risk of stillbirth since the baby wasn’t getting the nutrients he needed. Obviously, there was no contest. Paul, my husband, and I looked at each other. “Book me in”, I said. The doctor laughed out loud when he saw our faces when he offered us a slot the following day. Although we were warned that induction can be a lengthy process for a first-time baby, we couldn’t believe that within a few days we would be parents.
I had only finished work for maternity leave a week before and had been looking forward to 3 weeks of me-time before the baby arrived. I immediately regretted working so late and wished I had finished earlier. I felt like I had been robbed of this time that I had looked forward to, not simply because I wanted to get really stuck in with my nesting and because having feathered said nest, I wanted to put my feet up and relax, but also to process and take stock of the transition from a working professional to a mother. It felt like I went from one to the other, with no chance to think it through or unwind before I took on a totally new role that was 24/7.
I was anxious about the prospect of the induction. I’d said all along I would prefer not to have this. I knew that an induction meant the likelihood of other interventions was increased too, and I could feel my beautiful Birth Preferences slipping away from me. This wasn’t what I wanted or hoped for. I knew that plans changed, and I was prepared for this to happen, but it didn’t mean I liked it.
The Induction
Fast forward to the induction process, which was quite straightforward – they popped in a pessary at nighttime and by the following morning I was having contractions. It had worked much faster than anyone expected, least of all me, who was anticipating multiple pessaries, gels etc. Still, things were nice and calm – we had a little walk around the hospital (Paul anxiously looking around for help every time I stopped to breathe through a contraction as though I was going to give birth there and then in the corridor!) I had some paracetamol, I got in the nice warm birthing pool (reassured by the fact that I wouldn’t be pushing in there, hence no need for Paul to don his little net!), and then I went on the TENS machine.
‘These contractions are totally manageable’, I was thinking as I bounced on a birthing ball eating a bowl of sticky toffee pudding, ‘I’m not sure what people go about. This isn’t bad at all.’
Famous. Last. Words.
After my waters had been broken (another thing I had expressed a preference not to have and yet found myself talked into since things weren’t progressing any further), I couldn’t believe it.
THE PAIN!! OH MY DAYS, THE PAIN
I looked at the midwife and said the words I hadn’t expected myself to say at all during this process. “I need an epidural.”
I was no fool, I’d seen the size of that needle during the antenatal classes via Microsoft Teams. I’d said to Paul under my breath at the time, “absolutely NO CHANCE.” I wasn’t a fan of needles at the best times and the idea of THAT going into my back was NOT GOING TO HAPPEN.
And yet, here we were. The pain was intolerable, I couldn’t cope with this for hours on end before this baby came. It had to happen. In the end I decided the best option was not to even look at all. The Anaesthetist arrived very quickly, and I stared resolutely at a tile on the floor while it was done.
But it didn’t work. I had it in my head that epidurals just worked. I know I’d been warned that they don’t for some people, but it never crossed my mind that I’d be one of them.
The Anaesthetist had another go. It worked for half my body. A different Anaesthetist had a go with stronger medication, it helped for sure but the pain was still there, albeit a lot more tolerable. I was surprised that I could feel anything though given I’d been told the strength of this medication.
Paul was very supportive, giving me sips of water through a straw, which was nice and giving me the gas and air. I got the sense he felt out of his depth and unsure what to do, but I didn’t have the emotional bandwidth to reassure him, even though he was doing fine and was exactly what I needed.
The contractions started coming so thick and fast that I wasn’t recovering from one before I was hit by the next one. The doctors were paged to administer some more medication to slow things down. I was told that I was dilating at 3 times the rate they would usually expect to see.
I just knew that having these interventions, while now clearly inevitable, had been something I hadn’t wanted for a reason. This was the reason!
By the time things had progressed to 10cm and I was pushing, and pushing for an hour, purple faced and exhausted, the epidural ran out….
No one had expected it to take this long, so the midwife hadn’t called the Anaesthetist to put more epidural in.
All of a sudden, I was in unspeakable agony. The pain was indescribable. My eyes were wild, I was in so much pain I couldn’t make a sound, I couldn’t move. I took so much gas and air, they had to take it away because I had too much. The baby’s heartrate dropped and didn’t come back up. And then it was action stations.
The Doctors were paged. I was asked to sign consent forms for forceps, or a caesarean section and the risks were explained. I remember a doctor telling me that I might need to have a hysterectomy, or I could die during the procedure. Obviously, this was terrifying and yet what option did I have at this point? I had to say yes, because frankly it was clear this baby wasn’t coming on his own. I had lost all my usual politeness by this stage, I was in so much pain, and while dimly aware that this wasn’t how I would usually speak to anyone, I snapped “I CONSENT. I consent to it all. Get this baby out now. I don’t care about the risks. Just GET. HIM. OUT.” The Doctors then went off to have a team briefing (at which point, I couldn’t even. I mean, seriously, a meeting?! Now?!) I understand now, they had to speak quickly to determine a plan, but at the time, I was furious! I remember sighing heavily and saying “Well, if you have to do it, Hurry. Up!”
The epidural was taken out and Paul was asked to scrub up. He was so flustered he started to take his clothes off in the middle of the room and I had to tell him through gritted teeth that he had to go to the bathroom to get changed. No one wants to see that right now!
We were wheeled through to theatres. In my mind, it all took forever to get to this point, but in hindsight I don’t think it was anywhere near as long as I thought. My sense of time was all off, influenced by the extreme pain I was in.
I had to haul myself from the bed onto a table. It took monumental effort and I held onto the fact that once I was on this bed, I was a step closer to this whole thing being over. I wasn’t even bothered about meeting the baby at this point, I just needed it to be done. The Anaesthetist put a spinal in, and again, this was something I’d said I hadn’t wanted. I had seen that needle too at the antenatal class. But jeez, the relief was incredible. Suddenly, there was no more pain. My legs looked like a mannequin’s legs, like they weren’t mine. I had no feeling in them at all, no feeling below the waist. I looked at them in the stirrups and it was bizarre. Paul was sitting beside me looking terrified. I didn’t even feel like I was there anymore, it felt like it was all happening to someone else. This is a common process called dissociation. It’s where things become too much for our minds to deal with, and our brain dissociates from what’s going on. It’s a survival mechanism to help us to deal with trauma.
Before I knew it, the Doctors had assembled, and I was being told to “PUSH, PUSH, PUSH.” I realised they must have the forceps to help, but I didn’t see any of the instruments.
The Birth of My Son…in none of the ways I had hoped or planned for
And then I saw him. A tiny purple body being pulled out of me, reflected in the theatre light above my head. There was no sound.
The baby doctors got to work; I couldn’t see him for all the doctors surrounding him. Time went by and it felt like forever. I asked again and again “is he alive? ….. is he alive?” A nurse stood by my side holding one hand, while Paul held the other. All the Nurse would say was “they’re working on him.” I thought in that moment that he was dead, that he was stillborn. I couldn’t believe after everything we’d been through; this was going to be the outcome. I imagined having to tell everyone that the baby hadn’t made it. Our families’ reactions. I was absolutely terrified. My heart was pounding and I felt sick with fear. This couldn’t be happening.
And then we heard the tiniest of squeaks which developed into a faint cry. Thank God.
I think for me, this time before we heard the cry was the worst of everything.
Worse than the pain, worse even than the subsequent knowledge that not only had I had an episiotomy that I hadn’t wanted, I also had a 3C tear between my vagina and my anus, all of which had to be stitched up (literally something even now I can’t actually think about because it gives me the heebie jeebies). For a while after the birth, every time I thought about that time between seeing a pair of tiny purple legs and hearing that faint cry, I cried myself.
The thought of what could have happened, and the thought of what some other families do go through is absolutely horrendous.
I Didn’t Get the Rush Of Love Everyone Speaks Of…I Was In Survival Mode
The moment of Alexander being put on my chest and seeing his little face for the first time was quite surreal. I didn’t get the rush of love that lots of women speak about, although I hadn’t fully expected to. I’ve heard enough birth stories in my time, to know that this isn’t always the case for everyone. If anything, I felt completely shell shocked and exhausted. It was 2am, I’d been up for absolutely hours and experienced the most pain I’d ever felt, and been in the most vulnerable state I’d ever been in. There is a video of me speaking to him gently and holding him close, but I have no real memory of it. I knew logically this must be my baby, given that I’d seen him being pulled out of me reflected in the theatre light above my head, but I didn’t necessarily feel all that attached to him. It felt like I was holding this baby and that his ‘real’ mother would be coming along anytime now to collect him.
We were taken to the Ward and deposited in a bay. My legs were still completely without feeling, I was attached to various machines that all started beeping and sounding alarms and I had no idea where I was or what we were meant to do next. It took a long time for someone to come, and when they did, the first thing they asked was whether I had fed the baby yet. It hadn’t even dawned on me to try in all honesty, and I wouldn’t have known how to. I felt bad. I was letting him down already. They helped me to hand express some colostrum for the baby and they helped us to put some clothes on him.
He was so tiny, exactly 5lbs 2oz as predicted by the scan, and he had to be in a heated cot wrapped in blankets and wearing a tiny, knitted hat to get his body temperature back up. Even though he’d been born at 37 weeks, so wasn’t technically classed as premature, to me he looked like a premature baby. His limbs were so thin, his facial features were sharp and without that chubby baby fat I had expected. He looked like a little doll actually. He was officially termed a ‘low birth weight baby.’ Paul and I were scared to pick him up or move him in case we hurt him.
One of the monitors sounded a loud alarm that it had finished whatever it was meant to be doing, and I asked one of the midwives if she could turn it off. She sarcastically said to me that hospitals have machine and machines make beeping noises and she couldn’t just turn it off because I didn’t like the noise, and then realised I was right that it had finished its cycle and she turned it off. I was annoyed and starting to want to go home but realising that given the nature of the birth and the fact that Alexander seemed so tiny and frail, we probably wouldn’t be going anywhere anytime soon. If there’s one thing I dislike, it’s being spoken to like I’m stupid and I felt incredibly cross about the midwife’s tone of voice.
I felt like a prisoner stuck on this ward, I wasn’t allowed to leave, and I knew I couldn’t anyway.
My legs didn’t even work again yet and I had a catheter in and a cannula in my hand. I was quite literally trapped.
I Was No Longer Important, On Day 1, My Needs Already Put On The Back Burner
I asked for some infamous tea and toast but it took another 2 hours to arrive. I hadn’t eaten in what seemed like forever and I was starving. It already was starting to feel like now I’d had the baby, I’d lost all importance. My needs seemed to be going on the back burner literally on day one of new motherhood.
Meanwhile our problems with feeding Alexander were just beginning. He was too tiny and weak to latch, despite many, many attempts to breastfeed him. Midwives were having to force feed him milk with a syringe 1ml at a time and even that was a battle.
I Have Never Felt So Vulnerable In My Life
When Paul got sent home at bedtime and it was just me and Alexander, I struggled on my own. It felt so unfair that he got to leave and get some rest and I was expected to be up all night with this tiny human we’d created together, all on my own. Some of the midwives were incredibly kind, and others were less so. I guess they were very busy so when I pressed my buzzer repeatedly to get help with feeding (as I’d been instructed), one commented under her breath that I was going to have to learn to do this on my own. I felt bad about myself that I couldn’t get him to feed, but also annoyed that I was being ‘told off’ for following instructions set out by another midwife earlier on because they were so worried that if Alexander didn’t properly feed soon, we’d be ending up transferred to the Special Care Baby Unit.
The following morning Paul was back at 8am on the dot waiting at the door to be let in by the staff. As soon as I saw him, I broke down. I was crying and crying and crying. I felt so distraught but couldn’t even identify why. I’ve never felt as vulnerable in my life and I COULD NOT STOP CRYING. Fortunately, different staff were on now, and a new midwife in charge stepped in and transferred us from a bay to a room and gave permission for Paul to start to stay over. I was so incredibly relieved, thank God I wasn’t going to be alone here for more time.
I was being administered pain medication every 2 hours, and stool softeners to help ease things for when I had to use the toilet given that I had lots of stitches down below that I did not want to split! My pelvic floor was shot at, I had no control over my bladder. I found it painful to walk. I was bleeding heavily. I was exhausted. Struggling with feeding. Alexander developed jaundice and had to have treatment for that. I was desperate to get home and also terrified to leave. The midwives told us again and again that if Alexander lost any more weight even once we’d left, we’d likely be readmitted. He was now 4lbs 11oz, tinier than ever and showing no real signs of wanting to feed. It was just awful.
My Initial Postpartum Experience, Was Just as Traumatic as The Birth Itself
When I think back on the birth experience, this time in hospital after the birth is perhaps just as traumatic in its own way as the birth itself. Once we were released from hospital, things got even worse as I just could not get Alexander to breastfeed. We would sit there for hours with him screaming and me crying before I felt so frustrated and rejected, that I would pass him to Paul to feed him with a bottle, and I would have to leave the room. I didn’t feel like we were bonding. I couldn’t understand why I’d wanted to be a mother so badly, and then the reality was that I was having an absolutely terrible time and I didn’t feel like I was doing a good job of it at all.
In fact, it felt like I was failing at the first hurdle.
It took time for me to come to terms with the birth, the aftermath of the birth and breastfeeding trauma. The latter was every bit as difficult as the birth trauma because of the pressure I felt to breastfeed and the fact that everyone seemed to be insinuating that it was the most natural, easiest thing in the world, and yet I couldn’t do it. One friend was so convinced I must be doing it wrong, that she offered to breastfeed him herself, which made me feel absolutely dreadful that clearly everyone thought I must be totally incompetent.
When it was eventually found that Alexander had a tongue tie, that was at least an explanation for why it had been so hard, but by this stage he had such a preference for the bottle that we ended up having to give up even trying to breastfeed. It wasn’t worth the stress for him or for me in the end and I found a group online about exclusive pumping. I pumped breastmilk for him for a year to give him in his bottle, at least 5-7 pumps a day 24/7. It was a huge commitment to say the least, but it gave me and Alexander chance to properly bond without the stress of breastfeeding. While I was envious of those mothers who had babies who would simply latch on and didn’t have to be chained to a pump and sterilising pump parts at all times of the day and night, I did come to accept that this was my choice in order to provide breastmilk to my baby which was important to me and it was a compromise between me and him of a sort.
Ultimately the trauma of the birth and the aftermath of it, was incredibly difficult. I was fortunate in that I didn’t develop any symptoms of Post Traumatic Stress Disorder. I do think this was partly because I had anticipated that plans do change, partly because I had never had a bad experience with health professionals in the past and so had no reason not to trust them to do their best for me and our baby. Also, because Paul and I were able to speak about the birth openly after the event and I even attended a birth debrief in which the facts were explained to me about why each decision was made as it was.
My Advice, To Anyone Who Can see Themselves In My Story
I would recommend attending such a debrief for anyone struggling after giving birth, and I would hugely recommend reaching out to a therapist well trained in treating birth trauma if you are having any flashbacks or nightmares about the birth or feel like you haven’t processed it and moved forward.
Help is out there, and you don’t have to struggle alone.
It’s not normal to have to live with these symptoms and it is very, very treatable. This experience is life defining, so, my darling, make sure it’s defining for the right reasons and that the trauma of a birth doesn’t affect the rest of your life and your relationship with your baby.
You are amazing – you grew and birthed a tiny human being. That is a pretty incredible thing to have achieved! You haven’t failed if you didn’t have the birth you wanted, you did what you had to do to keep yourself and your baby safe. You haven’t let your baby down if you couldn’t feed them as you wanted to – you did what you had to do to help them grow and thrive. This is not easy – motherhood is 24/7 and it starts as soon as that baby is placed in your arms. You’re doing an amazing job!
Sarah x
